Homestead_Michel (8)�a n�3
ea �; CLAIM FOR HOMESTEAD PROPERTY TAX - -
;; �,: CREDITISTANDARD DEDUCTION
.�. .�.�;• State Form Sa73 (R2 / 5-92)
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INSTRUCTIONS: See reverse side lor /iling instructions.
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I(We) _ �I [��/y�¢��� certify.thal on the 1st day of March, 79
I(W�) occupied our r,cipal place of residence ihe following described real propeny for which a Homestead Property Tax Credit is hereby claimed:
�(We) owned ❑ Are buying under contraci ��
Have a beneficial interest in the entity that is liable for the property taxes on ihe property and that owns the property or is buying under a contract.
It buying on contract, Fee Simple ownets name
Recordefs oHice where contract is recortled
Cauniy
n of
Township
Legaldes
idential stru�re o ihe land not
�D prOduCe inCAme.
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RECORDED
Record number � Page
PROPERTY DESCRIPTION
. Tating diSVicl (CRy, towq fown5hip)
��S.ur��/-3 -lo �34/�L
one (1) acre that immetliatey surwunds that stmcture is used to produce inmme, tlescribe the use and portion
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PROPERTV.OWNED BY CLAIMANT IN OTHER COUNTIES
Caunty Township Counry Township
I hereby certify ihe above statements are true, correct and complete. Signamre of Gaimant
�iess (number and sfreel, ary, s1are, ZIP code)
ASSESSOR USE ONLV
Land noi exceeding 1(one) acre immediately
surrounding residential improvements.
Otherland
Total land (line 7 plus line 2�
Dwellin9
Residential improvements
Garage
Other improvements
Total improvements (line 4 through lina �
Total value (line 3 p�s line 7�
I hereby certify ihe above is Irue, correct, and
wmplete.
Oi �UlduOt
19_Payt9_
Lesser of t/2 Homestead
Valuation or $2.000
TRUETAX ASSESSED HOMESTEAD
. VAIUE VAWE VALUE
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(z)
(3)
(4)
(5)
(6)
(�)
(8)
Signawre of Assesmr
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NON-RESIDENTIAL
VALUE
Date signed
Date si9netl
Date